Tuesday, March 31, 2009

gray zone

working vs. learningscutmonkey comic from the underwear drawer, a brilliant blog by michelle au, a pediatrics-resident-turned-anesthesiologist. she is working on a book which is sure to be hilarious and fantastic. and no, i am not just praising her so that she doesn't sue me for using her image.

existing in a gray (grey's?) zone between education and indentured servitude, residency can be a strange thing sometimes. most of the time (ie: on wards, ICUs, ED, primary care clinics, etc), we are doing a job. in fact, we are the yoked oxen of the medical system, churning out paperwork and getting all of the annoying stuff done that no one else really wants to do.

at our institution, residents are the first physicians to greet the patient in the ER and often the last one to sign them out of the hospital (in addition to the nurse doing the formal discharge). we call in their prescriptions, order meds and handle crises in the middle of the night, and bring consultants together. often (such as in primary care clinic) we operate fairly independently -- there are many times the attending will sign off on a resident's recommendations based on a report without seeing the patient, if there are no specific concerns.

in general, most of the time we are needed. this is best illustrated by the frustrating fact that on most rotations, you can't even call in sick without bringing in a replacement. it's stressful, but gratifying.

other times, like now, we shift gears and get to be learners. in these situations, we are pretty much useless decoration and are there solely to expand our own pediatric horizons. interestingly, time moves infinitely slower in these sorts of situations, and the whole thing feels like an instant demotion. yesterday at the dentists office i explained to many people what a resident was ("you know, like meredith on grey's anatomy!") after being repeatedly asked how much longer i have in school.

maybe i shouldn't take offense to that, but while residency is still growing/learning/training, i already went to school for 18 years and i really think that's enough. people are often surprised that we get paid -- seriously, if i had to do this for free (or pay to do it!) it would have been time to quit long ago.

my ID badge says "MD, MS*" -- and i've been asked before whether the MS stood for 'medical student.' yes, everyone -- i'm a medical student with an MD. because that would make sense. right.

again, i don't really know why i care. i guess i should just relax and enjoy feeling like a kid again, with no responsibilities other than to myself. because it won't last. but it doesn't feel as good as one might think. i guess i'll try to work on it.

* my MS is for a master's in pharmacology -- i didn't ask them to put that on the badge, but it's there.

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3.30.09

workout: 1 hour spin class (including warmup / cooldown) + 30 minutes of yoga for runners. i tried yogadownload's detox yoga and it was wayyyy over my head -- i got so lost! i'm not going to give up, though. by the way -- today is is the last day to order yogadownload classes at half price! you can do so with code carrotsncake.

my HR in spin was only average 166. i think i might not have pushed it as hard as usual, although i saw it climb into the 180s during some more difficult segments.

doin' time: i LOVED the recipe i made last night! apricot almond chicken with mint pesto is the official title, but it is even better because it is crispy on the outside and contains melty GOAT CHEESE as well, bringing it to the zenith of deliciousness. seriously, this ranks among my all-time favorites from the cookbook i'm working through. it looked intimidating, but actually wasn't all that hard and was amazingly mouth-wateringly good. served with a simple spinach salad with citrus vinaigrette, and some little pieces of challah i found in the freezer (leftover from a french toast attempt!).

close-up, because it was THAT GOOD:


reading: 30 minutes on the AAP recommendations on pediatric dental care. did you know that ideally, kids should be seen by a dentist by age ONE? i didn't.

flossing: inspired by the dentist's office, oh yes i did.

13 comments:

da said...Best Blogger Tips[Reply to comment]Best Blogger Templates
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da said...Best Blogger Tips[Reply to comment]Best Blogger Templates
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da said...Best Blogger Tips[Reply to comment]Best Blogger Templates

A tip to all: if you want to see the comic strip enlarged, click on "the underwear drawer" link and then click on the comic strip there.

da said...Best Blogger Tips[Reply to comment]Best Blogger Templates

P.S. Sarah, I love your "yoked oxen of the medical system" metaphor. Did you coin that?
L, da

Jenny said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Thanks for this post! As a medical student I love getting the resident perspective. Residency has always seemed to be such a weird purgatory to me - it's a job, and you are a doctor, but you're also supposed to be learn and it's also not really like you have a choice about doing it like you would in a real job. The medical world can be so convoluted sometimes. Anyway, thanks again for a great post and a great blog in general!

Michelle said...Best Blogger Tips[Reply to comment]Best Blogger Templates

I liked this post. It was really interesting. As a young lawyer, I often get mistaken for a paralegal (there might be some sexism playing there too). Good job on the flossing :)

Jess said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Oooh goat cheese...

The new niece is adorable and I definitely think it's possible to do the half marathon, especially if you do it "for fun" instead of racing.

HangryPants said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Re: yoga downloads - did you look at the pose guide before you did it?

kt said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Hey Sarah,

That dinner looks/sounds delish!

And, regarding pediatric dental visits, I am so amazed to hear that kids should be seen by age 1. With each of my boys I've asked dentists and our pediatrician -- and everyone has told me to wait wait wait until at least 3 or later, when they can sit in the chair and have a full check up. I was asking because it seems like someone would want to see how the teeth were doing prior to year 3 or 4! So, thanks. :)

Kath said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Wow, that does look delish!!!

sarah said...Best Blogger Tips[Reply to comment]Best Blogger Templates

da: yep, my term :) it's true, though.

jenny: yes, purgatory! although i have to admit in some ways residency is more 'hell' than medical school. . . being an attending certainly looks like heaven. i wonder where fellowship will fall . . .probably purgatory, part II.

michelle: hmm, definitely could be some sexism in there too. when i first saw your comment i thought it was the scutmonkey author coming to yell at me for posting her stuff!

jess: i LOVE goat cheese. i feel like i should eat it more than i do.

heather: i really didn't study it that well -- you got me! next time i guess i'll have to! i was definitely confused. like, which leg? WHERE? how? wha? . . .followed by toppling over.

kt: well, there may be some controversy there. we were also taught to tell our pediatric patients age 2-3! but in the latest american academy of pediatrics guidelines (approved by the ADA), the rule was 1 (or 6 months after 1st tooth eruption whichever was earlier). so, maybe there's a change in protocol coming.

kath: from the master of delish that's a huge compliment :)

atilla said...Best Blogger Tips[Reply to comment]Best Blogger Templates

still wearing the yolk...dinner looks gr8

Bred Thompson said...Best Blogger Tips[Reply to comment]Best Blogger Templates

The post is rather interesting. The blog site is great too.
The dish looks pretty yammy!

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